Between 1990 and 2000, the U.S. Hispanic population increased by 58 percent, becoming the fastest growing and largest minority group in the country. Cardiovascular disease remains the leading cause of death among Hispanics in the U.S., both for immigrants and non-immigrants. Some studies demonstrate that control of cardiovascular risk factors is worse for Hispanics compared to non-Hispanic whites and blacks. However, the mechanisms underlying these disparities have not been elucidated. Language has been postulated as one potential mechanism to account for these underlying disparities. Spanish-speaking [unreadable] Hispanics are less likely to be screened for cardiovascular risk factors than English-speaking Hispanics. However, it is not yet known whether language is associated with poor control of cardiovascular risk factors. Furthermore, no study to date has ever examined the effect of patient-physician language concordance on screening of cardiovascular risk factors. The aims of this research proposal are three-fold. Data from the National Health and Nutrition Examination Survey 1999-2004 will be utilized to accomplish the first two objectives. The first aim is to examine the relationship between acculturation and obesity prevalence in the U.S. Hispanic population, [unreadable] while exploring the role of diet and physical activity on any observed differences. The second aim is to determine whether lower acculturation is associated with worse control of hypertension, hyperlipidemia, and diabetes among participants with these known cardiovascular risk factors, after adjusting for obesity. The third objective is to review medical records of Hispanic patients from two primary care centers in Boston to determine if Spanish-speaking Hispanic patients who are cared for by non-Spanish speaking physicians have poorer rates of cardiovascular risk factor screening compared to Spanish-speaking Hispanic patients cared for by Spanish-speaking physicians. [unreadable] These projects have important implications in NHLBI's mission to improve prevention, diagnosis, and treatment of cardiovascular disease, particularly in the U.S. Hispanic population. The first project will identify acculturation status as a possible determinant of poor cardiovascular risk factor control. This project will also allow us to understand how diet and physical activity affect the relationship between acculturation and obesity. The second study will allow us to identify a mechanism by which Hispanics in the U.S. are subject to underdiagnosis of cardiovascular risk factors. These two combined projects will serve to identify possible areas for future interventions to improve cardiovascular health for the U.S. Hispanic population. [unreadable] [unreadable] [unreadable] [unreadable]